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KMID : 0882420050680010026
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Korean Journal of Medicine
2005 Volume.68 No. 1 p.26 ~ p.38
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A clinical study on liver abscess for recent 15 years in gwangju, chonnam province
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Seo Tae-Jin
Park Chang-Hwan
Lee Wan-Sik
Joo Young-Eun
Choi Sung-Kyu
Rew Jong-Sun
Kim Sei-Jong
Park Jae-Hong
Kim Hyun-Soo
Lee Soo-Jung
Lee Seung-Hwan
Park Jeong-Ho
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Abstract
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Background: The mortality of liver abscess markedly decreased because of the improvement of diagnosis and treatment modalities, however, the incidence is still high and various complications have been developed. Our study was to clarify the clinical features, complications, changing patterns of causative organisms and predicting parameters for development of complications in liver abscess.
Methods: We reviewed 197 cases of pyogenic and amebic liver abscesses treated at Chonnam University Hospital from January 1989 to March 2003. These cases were divided into subgroups by time of occurrence, and the data was reviewed comparatively. Predicting parameters for development of complications in recent 5 years were also analyzed.
Results: The male to female ratio was 1.59 : 1 and the peak incidence age of liver abscess was in the 7th decade. There were no significant interval changes in incidence of pyogenic liver abscess (96.4%) and amebic liver abscess (3.6%) from January 1989 to March 2003. The most common infection route in pyogenic liver abscess was biliary tract (45.8%), followed by cryptogenic cause (44.2%), pulmonary disease (2.6%), hematogenous (2.1%) and abdominal trauma (1.5%). The pus culture came out positive in 50.4% of pyogenic liver abscess. Klebsiella pneumoniae was the most commonly isolated organism in pyogenic liver abscess (32.9%). The significant predicting parameters for development of complications were age (≥60), systemic inflammatory response syndrome (SIRS, ≥2 factors), C-reactive protein (CRP, ≥8mg/dL), bilirubin (≥2mg/dL), albumin (＜3g/dL) and AST (≥200 IU/L, p＜0.05).
Conclusion: There were no significant interval changes in etiologies and predisposing conditions of liver abscess in Gwangju, Chonnam Province from January 1989 to March 2003. Age, SIRS, CRP, bilirubin, albumin and AST were considered as significant predicting parameters for development of complications in liver abscess.
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KEYWORD
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Liver abscess, SIRS, C-reactive protein
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